Pain physician
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Randomized Controlled Trial
A Prospective Randomized Noninferiority Trial Comparing Upper and Lower One-Third Joint Approaches for Sacroiliac Joint Injections.
Sacroiliac intraarticular injection using the upper one-third joint technique is recommended for injections that are difficult with the lower one-third joint technique. ⋯ Fluoroscopy, low back pain, lower one-third joint technique, sacroiliac joint, sacroiliac joint injection, upper one-third joint technique.
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Knee osteoarthritis (KOA) is a very challenging condition to treat and can be resistant to medications, procedures, and even surgery. Surgery may not be an option for some patients due to obesity or comorbidities. Regenerative medicine utilizing stem cells, platelet rich plasma (PRP), amniotic fluid, and cytokine modulation is very promising in the treatment of KOA. ⋯ Knee osteoarthritis, stem cell, treatment, platelet rich plasma, amniotic fluid, articular cartilage defect.
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Randomized Controlled Trial
Comparison of Epidural Spreading Patterns and Clinical Outcomes of Transforaminal Epidural Steroid Injection with High-Volume Injectate via the Subpedicular Versus the Retrodiscal Approach.
The effect of transforaminal epidural steroid injection (TFESI) appears to be influenced by the volume of the injected material because there is a positive correlation between injection volume and extent of pain relief. ⋯ Epidural spreading patterns and clinical outcomes of lumbar TFESI with high-volume injectate were not significantly different between the SP approach and the RD approach.Institutional Review Board (IRB) approval: Institutional Review Board of Ewha Womans University Hospital (EUMC 2015-05-003-003). Clinical trials registration number: Clinical Research Information Service (CRIS, registration number: KCT0002288; RCT URL: https://cris.nih.go.kr/cris/search/search_result_st01.jsp?seq=7309)KEY WORDS: Epidural injections, epidural space, low back pain, radiating pain, disability evaluation, steroids, local anesthetics, intervertebral disc disease, spinal stenosis.
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Levels of prescription opioid (PO) dispensing have been rising in Canada - also in global comparison - since the mid-2000s, and are co-occurring with extensive PO-related morbidity and mortality. Previous analyses have demonstrated correlations between PO dispensing and related harm levels, yet also distinct heterogeneous interprovincial PO-dispensing patterns, in regards to quantities and individual PO formulations. Several system-level interventions have been implemented recently (since 2012) to address high PO-use levels and related harms in Canada; the effects of these interventions on PO-dispensing levels remain largely unexamined. ⋯ Opioids, prescribing, dispensing, interventions, policy, population, monitoring, Canada.
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The use of percutaneous endoscopic lumbar discectomy (PELD) is increasing in the treatment of lumbar disc herniations (LDH). Nerve and vessel injury may happen during the establishment of the transforaminal working channel. Also, there is usually exposure to intraop radiation when the C-arm is used to help establish the location of the transforaminal working channel. ⋯ Lumbar disc herniation (LDH), ultrasound volume navigation (US VNav), percutaneous endoscopic lumbar discectomy (PELD), foramen, puncture.